The prevalence of smoking among Croatian hospitalized coronary heart disease patients

The aim of this paper was to investigate the prevalence of smoking using selected anthropometric variables in a sample of hospitalized coronary heart disease (CHD) patients in Croatia (N = 1,298). A total of 444 subjects (34.6%) were non-smokers, 548 (42.6%) were smokers and 293 (22.8%) were ex-smokers. Men, on average, smoked more cigarettes per day than women (22.62 vs. 19.84 cigarettes, p < 0.001) and they also had bigger index "pack-years" than women (36.96 vs. 33.91, p = 0.024). Men were more often smokers and ex-smokers than women (47.4% vs. 30.8% for smokers and 25.0% vs. 22.8% for ex-smokers, p < 0.001). In this study a high prevalence of smoking was found among CHD patients in Croatia. Unless it is decreased, it can be expected that CHD patients in Croatia will continue to experience adverse effects more often than other CHD patients in the rest of Europe.     

The prevalence of hypertension among Croatian hospitalized coronary heart disease patients

The aim of this article was to investigate the prevalence of hypertension with selected anthropometric variables in a sample of hospitalized coronary heart disease (CHD) patients in Croatia. This study investigated patients hospitalized in the period of October 1st 2007 until January 7th 2010 because of acute or chronic CHD in various hospitals in Croatia (N = 1,298). Prevalence of hypertension in surveyed patient population was high: 70.1% of participants had raised blood pressure (BP) or previously diagnosed hypertension. Men had statistically significantly higher mean diastolic BP values than women (78.91 +/- 8.97 vs. 77.12 +/- 10.61 mmHg, p = 0.011). Prevalence of hypertension was statistically significantly more frequent in women (80.6% vs. 65.8%, p < 0.001). Hypertension still represents an important problem among hospitalized Croatian CHD patients. Its prevalence, unfortunately, continues to increase in this population, suggesting that there is still great potential for improvement of preventive cardiology standards and measures that have already been undertaken.     

The prevalence of overweight and obesity among Croatian hospitalized coronary heart disease patients

The aim of this article was to investigate the prevalence of overweight and obesity using selected anthropometric variables in a sample of hospitalized coronary heart disease (CHD) patients in Croatia (N = 1,298). Prevalence of overweight and obesity in surveyed patient population was high: 48.2% of participants were overweight and 28.6% were obese according to their body mass index; measured through waist-to-hip ratio 54.5% of participants were centrally obese. These data on prevalences of overweight, obesity and central obesity show that although there are some reassuring trends, there is still considerable amount of work to be done if the prevalence of this cardiovascular risk factor is to be reduced further among Croatian CHD patients. While the prevalence of obesity seems to be on the decline, the prevalence of overweight is rising, which may be just an early warning sign of an incoming wave of obesity epidemic in future years.     

Retrospective study of the prevalence of high-risk human papillomaviruses among Croatian women

The infection with Human papillomavirus (HPV) is the necessary cause for cervical cancer. There are at least 15 High-Risk (HR) HPV types that are significantly associated with progression of cervical intraepithelial neoplasia to cervical cancer. Since previous studies showed that the prevalence of HPV in cervical cancers varies among different geographic regions, we wanted to investigate the prevalence of HPV types in Croatia, especially low abundant HR HPV types. By means of consensus primers directed polymerase chain reaction (PCR), we analysed cervical DNA samples of 2,136 Croatian women, mostly with abnormal cervical smears, in order to detect the presence of HPV Type-specific primers were then used to determine Low-Risk (LR) HPV types 6/11 and HR HPV types 16, 18, 31, 33, 45, 52 and 58. Out of 2,136 specimens, 1,255 (58.8%) were positive for HPV More than half of positive samples were typed (64.5%) and 35.5% still remained untyped. Multiple HPV infections were found in 10.3% of the cases. The most prevalent type, including both single and multiple infections, was HPV16 with the prevalence of 15.9%, followed by HPV types 31, 6/11, 33, 18, 52, 45 and 58 with 8.7%, 7.1%, 4.5%, 3.8%, 2.3%, 1.2% and 1.1%, respectively. The significant increase of frequency from Low-grade Squamous Intraepithelial Lesions (LSIL) to High-grade Squamous Intraepithelial Lesions (HSIL) was observed for HR HPV types 16, 18, 31 and 33 but not 45, 52 and 58. The frequency of unknown HPV types was almost the same in cervical specimens of women with LSIL and those with HSIL, 19.8% and 21.1%, respectively. The prevalence of HPV infection rate decreased significantly with patient age from 68.5% (age group 12 to 24 years) to 38.8% (age group 45 to 54 years). But, in women aged 55 or older the overall prevalence increased to 56.6%. Our results indicate that prevalence of HR HPV types in Croatia is similar to other countries. We suggest that HPV positive women in Croatia should be closely monitored by typing for HR HPV types: 16, 18, 31, 33, 45, 52 and 58.     

The prevalence of diabetes mellitus and abnormal lipid status among Croatian hospitalized coronary heart disease patients

The aim of this article was to investigate the prevalence of diabetes mellitus and abnormal lipid status with selected anthropometric variables in a sample of hospitalized coronary heart disease (CHD) patients in Croatia (N = 1,298). Prevalence of diabetes mellitus was 31.6% (statistically significantly more frequent in women, 35.7% vs. 30.0%), while prevalences of increased total cholesterol were 72.0%, decreased HDL-cholesterol 42.6% (statistically significantly more frequent in women, 50.2% vs. 39.6%), increased LDL-cholesterol 72.3% and increased triglycerides 51.5%. Reported data on prevalences of diabetes mellitus can be somewhat reassuring (a decrease in its prevalence compared to data from 2006, but they still signal a situation which is a lot worse than in 2002 and 2003); the trend of rising prevalences of dyslipidaemic cardiovascular risk factors must be a cause for an alarm, furthermore as today's preventive and treatment measures in cardiology, both primary and secondary, are strongly focused on dyslipidaemias.     

A neuropsychological analysis of the lack of school achievement among the pupils of mass schools]

We describe typology of neuropsychological organization underlying the cognitive difficulties of 6-10-years-old schoolchildren. In 10-20% subjects under study was revealed a deviant ontogenetic development with minimal cerebral disfunction, accompanied by systemic insufficiency of certain mental functions. Ontogenetic development of left-handed subjects as well as of right-handed ones with partial and/or family left-handedness was found to be atypical. About 80% of right-handed subjects with normal cognitive development displayed disorganization of some components of mental activity as a consequence of heterochronous morphofunctional maturation of the brain. Specific correction programs should be developed for each group of children under study.     

The prevalence of cardiovascular disease risk factors in patients from Croatian Zagorje County treated at Department of Medicine, Zabok General Hospital from 2000 to 2006

The aim of the study was to assess the prevalence of risk factors for cardiovascular disease in patients treated for coronary heart disease (CHD) at Department of Medicine, Zabok General Hospital during the 2000-2006 period. Cardiovascular diseases are a group of diseases that occur due to arterial. The risk factors that lead to the development and occurrence of cardiovascular disease are hypertension, cigarette smoking, hyperholesterolemia, hypertriglyceridemia, diabetes mellitus and positive family history. Additional factors favoring the occurrence of cardiovascular disease include overweight, inadequate physical activity, and emotional stress. Data on all patients hospitalized and diagnosed with CHD at Department of Medicine, Zabok General Hospital during the 2000-2006 period were analyzed for the prevalence of risk factors for CHD, i.e. hypertension, cigarette smoking, hypercholesterolemia, hypertriglyceridemia, diabetes mellitus and positive family history of cardiovascular disease. Hypercholesterolemia was defined by a cholesterol level higher than 5.1 mmol/L, hypertension from history data and blood pressure measurement on admission greater than 140/90 mmHg, diabetes mellitus from history data, and hypertriglyceridemia by a triglyceride level greater than 1.7 mmol/L. Information on heredity and cigarette smoking was collected from history and a questionnaire filled out on admission. All laboratory values were determined on patient admission to the hospital. Analysis of the risk factors for CHD recorded in patients from Zagorje County during the 2000-2006 period revealed hypertension to be the most common risk factor in our patients. According to sex, CHD was found to show a male preponderance. According to age at admission, CHD predominated in the > 70 age group, which accounted for one third of all patients, followed by a comparable proportion of the 50-60 and 60-70 age groups, i.e. still active population groups. As CHD is one of the leading health threats worldwide, estimated to remain so at least by 2020, it is fully justified to invest all efforts in the study of cardiovascular disease. New research projects should be focused on the prevention and early detection of the disease, improvement of diagnosis procedures, introduction of novel therapeutic options, use of new concepts, and due survey of the measures taken. CHD poses great socioeconomic burden upon every community in industrialized societies because of the ever younger age at onset. Actions should be taken to improve awareness of the CHD risks and morbidity in the population at large, stimulating favorable lifestyle and dietary modifications, and one's own health awareness, in order to upgrade the control of risk factors for and morbidity of cardiovascular disease.     

Tobacco smoking causes secondary polycythemia and a mild leukocytosis among heavy smokers in Taif City in Saudi Arabia

Tobacco smoking is a common risk factor of cardiovascular diseases, cancers and heart health problems. In Taif, the number of secondary polycythemia patients is increasing dramatically and most of those patients are heavy smokers. Therefore, this study is an attempt to understand the pathophysiological mechanism behind that problem. Whole blood and serum samples were collected from forty healthy people and forty tobacco smokers, voluntary for this study. Complete blood counts revealed a significant increase in the red blood cell count, hemoglobin concentrations, hematocrit and neutrophils with some elevations in total white blood cells, lymphocytes and monocytes. Moreover, serum analysis of both erythropoietin and interleukin-7 showed a significant reduction in their levels among smokers which were about 35% and 65% respectively. Gene expression study showed a significant upregulation of RAG-1, RAG-2 and EPOR-1 genes caused by tobacco smoking. In conclusion, data presented in the current study suggest that tobacco smoking might cause alveolar tissue inflammation and vascular injury causing an immune response that elevates the white blood cells count. Another suggestion is that tobacco smoking defects the pulmonary gaseous exchange mechanism leading to the secondary polycythemia indicated by the increase in red blood cell count, hemoglobin levels, hematocrit and by the low serum erythropoietin levels.     

Distinguishing between primary and secondary intergradation among morphologically differentiated populations of Anolis marmoratus

Distinguishing between primary and secondary intergradation among differentiated populations, and the relative importance of drift and selection, are persistent problems in evolutionary biology. An historical perspective on population interactions can provide insight into the nature of contacts, and thus help resolve these questions. Continuously distributed populations of Anolis marmoratus from the island of Basse Terre in the Guadeloupean archipelago of the Lesser Antilles show a striking degree of geographic variation in morphology. Initial surveys of mtDNA variation from throughout the Guadeloupean Archipelago revealed one case where levels of sequence difference and phylogenetic relationships of alleles from morphologically differentiated populations from the east coast of Basse Terre were consistent with primary intergradation. In this paper, I examine the genetic population structure of a series of populations spanning this north-south cline in morphological variation to test the hypothesis of primary intergradation. Sequences of the mitochondrial cytochrome-b gene from 50 individuals representing five populations spanning the cline were obtained and fourteen unique haplotypes (differing by 2% or less) were detected. Patterns of nucleotide substitution among haplotypes do not deviate from neutral expectation indicating no effect of selection at the level of mtDNA sequences. Estimates of population structure and gene flow were made using both summary statistics for nucleotide diversity (N_at) and cladistic methods. The results are sensitive to the choice of gene flow model, and this is discussed in detail. Mitochondrial variation in the northern populations may not be at equilibrium, and the phylogeny of alleles is consistent with a recent increase in effective population size. Estimates of nucleotide diversity, gene flow, and the phylogenetic relationships of haplotypes indicate that the southern-most population (representing the extreme of morphological variation along this cline) has been relatively isolated from populations to the north and has experienced a reduced effective population size. The apparent clinal variation between the southern population and the others may therefore reflect secondary contact and introgression rather than primary intergradation.     

Study of smoking habits in hospital and attitudes of medical staff towards smoking.

Most hospital policies place little or no restriction on patients'' smoking in hospital. In this study patients were surveyed to determine if they smoked and if their doctors advised or ordered them to stop smoking in hospital. As well, the smoking habits and attitudes towards smoking of the medical staff and other hospital workers were explored. Of 741 patients 37% were smokers, and those who responded fully to a questionnaire 86% continued to smoke in hospital. Patients who were advised or ordered not to smoke (59%) were no more likely to stop smoking than those who were not so advised or ordered. Physicians were less likely to smoke than other hospital staff, and those who did smoke were much more likely not to smoke while in the hospital. Physicians appear to have a reasonable appreciation of the health hazards of smoking, and almost two thirds are in favour of stricter restrictions on patients'' smoking in hospital. The ineffectiveness of their efforts is primarily due to hospital policies that are not in keeping with physicians'' standards of practice and with established knowledge of the deleterious effects of smoking on health.     

Disciplinary attitudes and cigarette smoking: a comparison of two schools.

Two British boarding schools for boys with different disciplinary policies in respect of cigarette smoking were identified. Questionnaires were sent to the young "old boys" of each school to determine their present smoking habit and most were returned (school A 81%, school B 83%). Significantly more responders smoked who had been to the less strict school (school A 39%, school B 30%, p less than 0.05). These figures probably underestimate the smoking prevalence in the two complete groups. The results suggest that measures that reduce the exposure of an uncommitted adolescent to peer group smoking decrease the chances of tobacco dependence in adulthood.     

Universities and medical schools: reflections on a half-century of Canadian medical education.

After 50 years of accelerated development, universities and medical schools have entered a period of uncertainty and instability. The Flexnerian paradigm of medical education, rooted in biomedical science and conducted under the aegis of a university, reached its apotheosis by the late 1960s and the early 1970s. Fuelled by the introduction of comprehensive, government-sponsored health care insurance and advances in technology, the demand for health care professionals and for access to facilities increased sharply. Medical education, research and advanced clinical services expanded dramatically aided by the emergence of academic health sciences centres and accompanied by a wave of medical curriculum reform. Now medical schools must strike a dynamic balance in responding to the continued expansion of knowledge and technology, the demand for social equity and the exigencies of prolonged fiscal constraint. They must also balance the biological and sociological approaches to medicine in establishing the foundations for the future development of Canadian medical education.     

Prevalence of moderate and severe depression among Croatian patients infected with human immunodeficiency virus

The aim of the study was to assess the prevalence of depression among Croatian patients infected with human immunodeficiency virus (HIV) and to make a comparison with patients with other acute and chronic infectious diseases. We assessed the depressive disorder using the Beck Depression Inventory questionnaire (BDI), without clinical confirmation. The BDI scores were examined in 80 HIV-infected persons and compared to 80 persons with chronic viral hepatitis and 78 with acute infectious diarrhea. All examinees were treated as outpatients at the University Hospital for Infectious Diseases in Zagreb in March and April of 2003. Prevalence of moderate and severe depression among HIV-infected was 16/80 (20%) with a 95% confidence interval 11% to 29%. Male patients with HIV or chronic viral hepatitis had a significantly higher BDI scores than males with acute infectious diarrhea (p = 0.017, Kruskall-Wallis, d.f. 2). Female patients with HIV infection tended to have a lower BDI score than females with chronic viral hepatitis or acute infectious diarrhea (p = 0.087, Kruskall-Wallis, d.f. 2). Prevalence of moderate and severe depression among Croatian HIV-positive patients is higher than the upper estimate for general population. Croatian males with chronic infectious disease have higher rate of depression than those with acute infectious disease.